Pediatric Final

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An infant born with a myelomenigocele should be in which position?: Prone position always or on side.
What are nursing priorities post-op for a myelomenigocele?: Avoid infection, antibiotics, sterile technique, maintain moist sterile, non-adherent saline dressing to sac.
What is the cause of myelomenigocele?: Severe genetic predisposition and folic acid deficiency from mother.
What are the different forms of spina bifida?: Spina bifida oculta (bony defect - missing bone)
Spina bifida dystica meningocele (meninges are exposed)
Myelomeningocele - meninges and spinal cord protruding.
What supplement is suggested to prevent this disease?: Folic Acid
How can spina bifida be predicted while still in utero?: Prenatal alphfetoprotein level checked at 16 weeks.
What are the signs and symptoms of hydrocephalus?: Neural functions
What are nursing priorities post-op for shunt placement?: Monitor for infection or malfunction of shunts.
What teaching should parents receive after a child gets a shunt?: Be able to recognize signs of infection to shunts
What symptoms do you look for if a shunt has complications?: Neural function stops.
What are signs and symptoms of an infant with ICP?: Irritable, double vision, dycoplia.
What nursing strategy is done to prevent increased ICP in the unconscious child?: Semi-fowlers position.
What should parents do with care of unconscious but stable child?: Talk, touch, and associate like normal.
What is an epidural hematoma?: Bleeding between the dura and skull.
What is a subdural hematoma?: Bleeding between the dura and the brain.
After a minor head injury, what S&S may indicate a need for medical help?: Change in Level of consciousness, change in behavior.
What is decorticate posturing?: Aduction of the hand and feet toward the cord.
What is decerebrate posturing: Abduction of hands and feet.
What symptoms do you see with spastic cerebral palsy?: Muscle stiffness.
What is the major goal of therapy for children with Cerebral Palsy?: Child will develop to the best potential.
What test is done to diagnose meningitis?: Lumbar puncture.
How is a lumbar puncture done?: Child is lying on his side. Hold the head and legs.
What specimen is obtained in a lumbar puncture?: Cerebrospinal fluid.
What is the priority nursing care for a child with bacterial meningitis?: Administer medication as soon as possible.
What vaccine is available to prevent meningitis?: Hepatitis B.
What type of illness precedes Reyes Syndrome?: Viral Infection such as the flu.
What does an absence seizure look like?: Daydreaming. Staring into space.
What information is important to gather about absence seizure?: When, type, how many episodes, any information.
After a tonic-clonic seizure, what symptoms would be expected?: Lethargy, Headache, sleepy, fatigue.
What nursing interventions are done for failure to thrive?: The parent needs to know when the child is hungry (feed on demand)
Mental retardation is caused by?: Various genetic biochemical, viral, nutritional factors.
IQ of 30 is described as?: Sever retardation (needs constant directional supervision)
The best method for early detection of cognitive deficit is?: Routine developmental assessment tests (Denver screening)
The priority nursing diagnosis for a child with cognitive dysfunction with limited ability to ancitipate danger is?: Safety
What is monitored during the first year of life in a child with Down's syndrome?: Cardiac and GI disorders.
What is the most common disorder of Down's Syndrome children?: Congenital heart defects.
What are the major features of a child with Down's Syndrome?: Simian Crease on palm, hypotonic muscles.
With a hospitalized child with Down's Syndrome, what would a nurse do?: Encourage the parents to stay with the child.
What is myopia?: Near-signtedness (image focusing in front of retina)
What is conjuctivitis?: Pink eye, bacterial, viral chemical, alergic infection (never touch the tip of the medication applicator)
Eye surgery puts a child at risk for?: Infection of the eyes
The priority nursing diagnosis for a child with eye surgery is?: Treat the patient as if their vision is impaired (announce your presence when entering the room)
How is the eye patch placed on a child for strabismus?: The patch is placed on the stronger eye to strengthen the weaker eye.
Is strabismus normal for a 5-month-old?: No. It's normal for a 4-month-old.
If an infant stops babbling, what should be assessed?: Hearing
How do nurses meet the needs of children with hearing loss?: Get their attention, look face to face.
What are the symptoms of visual-impaired children?: Squinting, rubbing eyes frequently.
What are signs and symptoms of hypokalemia?: Hypoactive bowel sounds, low potassium, below 3.5mEq/L.
What is the priority nursing diagnosis when caring for infants with dehydration?: Monitor I&O, daily weight checks.
What assessment should be done before administering IV solution with Potassium to a child with dehydration?: Urinating well.
What is the primary concern with persistant vomiting?: Find the cause.
Do we give antidiarrheal medication to toddlers?: No, will prolong diarrhea.
What are the teaching concerns with diarrhea in children?: Monitor skin turgor, monitor for low BP, tachycardia, mucous membranes moist, capillary refill.
What are the signs and symptoms of dehydration?: No urination for 6 hours, notify doctor.
How do we treat dehyration at home?: Oral rehydration, pedialyte, gatorade.
How do we avoid the spread of gastroenteritis?: Hand washing.
What are the complications of severe dehydration?: Renal failure, immature function of kidneys make children more prone to dehydration.
What is the most common test for pinworms?: Scotch tape test immediately upon wakening.
What is the cause of cleft lip?: Unknown
How do you help parents cope with cleft lip?: Show before and after surgery pictures. (Encourage parents to verbalize feelings.)
What is the post-op care for cleft lip?: Mittens, elbow restraints, do not put face down.
What is pre-op care for cleft lip?: Provide suction needs (pacifiers and nipples.)
What maternal conditions relate to the infants diagnosis of TEF?: Polyhydramnios (too much amniotic fluid)
What is the nursing care of an infant with TEF?: Place in upright position until surgery (NPO)
What is a major symptom of pyloric stenosis?: Olive size bulge in the RUQ, vomiting, visible perstalsis.
What is intussusception?: Telescoping of the bowels.
What is an assessment finding in infants with intussusception?: Current Jelly stool.
What is the first step in emergency treatment of poisoning?: Assess the patient first.
What is the most common source of lead poisoning?: Lead paint.
What is the discharge teaching for an infnat with GE Reflux?: CPR, Risk for aspiration.
What is celiac disease?: An intolerance to foods with gluten such as wheat, barley, rye and oats.
What is the priority nursing diagnosis for a child with celiac disease?: Altered nutrition less than body requirments.
What are classic symptoms of celiac disease?: Abdominal distention, thin arms & legs, foul smelling stool.
What is an assessment finding with hirschsprungs disease?: Constipation.
What is the nursing care post-op of Hirschsprungs disease?: No rectal temps, colostomy care.
What are the symptoms of a recently ruptured appendix?: Sudden relief of pain.
What are the appropriate interventions for a ruptured appendix?: No heat to abdomen, IV fluids, CBC, pain medications.
What is the treatment for thrush?: Antifungal cream. (apply to gums with gloves)
What is the oral treatment for ringworm?: Griseofulvin po q 12 hours.
What is impetigo?: Bacterial infection of the skin, papule and vesicle around the mouth.
What is the treatment for impetigo?: Antibacterial meds. 48 hr. after starting antibiotics - can return to school.
What causes cellulitis?: It is secondary to injury and infection.
What is the nursing priority for a child with herpetic gingivostomatis?: Risk for dehydration due to sore mouth.
What is the treatment for Herpes simplex virus?: Oral antiviral medication.
What are the side effects of anti-lice products?: Neuro toxin effects.
What are the signs and symptoms of lice?: Itching
What are the complications of atopic dermatitis?: Impetigo.
What are the classifications of burns?: First - Superficial
Second - Partial - Epidermis & Dermis
Third - Full - all 3 layers of skin
What is the relationship between the prognosis?: More tissue damage - more severe
What is the priority outcome of mandatory newborn screening?: Hypothyroidism
The lack of growth hormones lead to what metabolic alteration?: Hypoglycemia - low glucose.
What are the symptoms fo hypoglycemia?: Sweating, pallor, low sugar between 60-80, give simple sugars.
What is the honeymoon phase of diabetes?: The pancreas starts to produce insulin for 1-6 months.
What should a diabetic child do who plays sports?: Eat more carb snacks.
What is a good age to administer insulin?: Age 9-12
Know proper care for type 1 diabetes and need for education.: Teenager states "I can't wait till I'm older so I can take a pill"
What does a teenager with diabetes think?: I just want to be like everyone else.
What labs are associated with diabetes ketoacidosis?: Acidosis pH levels below 7.0
How should pH levels below 7.0 be treated?: Go to hospital - life threatening.
What are some teaching items for UTI prevention?: Cotton underwear, no bubble bath, cranberry juice.
What are the symptoms of UTI?: Abdominal pain, enuresis, dysuria, polyuria, hematuria.
Why are girls more prone to UTI's?: They have a shorter urethra and are more susceptible to infection.
What is a sign that a person with acute post-streptococcal glomerulonephritis is showing improvement or recovery?: Increased urination.
What are complications and symptoms of acute post-streptococcal glomerulonephritis?: Edema, crackles in lungs, tea color urine.
What does it mean if you have casts in the urine?: Glomerular injury.
What are diagnostic findings associated with nephrotic syndrome (Phephrosis)?: Protein in the urine, hypoalbumin, edema.
What is a sign that nephrotic syndrome (Phephrosis) is in remission?: No protein in the urine for 2 weeks.
What is the treatment for Nephrotic Syndrome (Phephrosis)?: Corticosteroids.
What is a no-salt diet?: No salt in cooking or on table.
What is a nursing intervention for a child with nephrotic syndrome?: Risk for impaired skin integrity - turn every 2 hours.
What is a teaching item for a child with vesicoureteral reflux?: Importance of taking antibiotics.
What is the best way to examine an infant for cryptorchisism?: Warm room, warm hands.
What age should hypospadias be accomplished by?: 18 months.
Why is it corrected early?: To maintain a good body image.
What is epispadias?: Dorsal placement of urethral opening.
What are the effects of chemotherapy?: Suppression of immune system (bone marrow)
What are signs and symptoms of leukemia?: Bone pain, weakness, pallor, bruising, weight loss, enlarged lymph nodes.
Why would a child scream when moving?: Bone pain.
What is the priority nursing diagnosis for a newly diagnosed leukemia patient?: Infection control.
What test is done to confirm a leukemia diagnosis?: Bone marrow biopsy.
Why does a leukemia patient have excessive bleeding?: They have low platelets.
What is a home going teaching item for parents of a child with leukemia?: Take temp routinely to catch infection in the early stages.
How do you respond to guilt about not taking child to Dr. sooner?: It is normal to overlook subtle changes in a child's health.
What are S&S of Hodgekin's disease?: Non-tender lymph nodes, enlarged firm, no pain, lethargy, pruritis.
What is the appropriate care for a child with Wilm's tumor?: Do not palpate abdomen
What is the post-op treatment for a child with Wilm's tumor?: Chemotherapy with or without radiation.
What are hallmark symptoms of a child with a brain tumor?: Headache, vomiting in the morning.
What is the significance of a neuroblastoma-embryonic tumor in utero?: Diagnosis after its metastis.
What is the most common site for a osteogenic sarcoma (bone cancer)?: Femur
What electrolyte disturbance causes cardiac dysrhythmia?: Hyperkalemia - High potassium levels.
What is the most common way of contracting HIV in children?: Perinatal
What are the signs and symptoms of malignant hyperthermia?: High temperature.
What is the appropriate way to give a tepid sponge bath?: If the child is chilled - stop bath.
What is the most reliable way to determine safe dosage for a child?: Body weight in Kg.
What is a nursing consideration when using a mist tent?: Keep the child warm and dry.
What is a papule?: An elevated circumscribed area such as a wart or mole.
What is a nodule?: An elevated area that is firm and round.
What is a vesicle?: An elevated area that is round, superficial such as chicken pox, herpes zoster.
What is a pustule?: A pus filled area such as herpes simplex or acne.

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